title: Patient experiences with communication about sex during and after treatment for cancer.
abstract: OBJECTIVE
  We studied patients' experiences with oncology providers regarding communication about sexual issues during and after treatment for cancer.
  
  
  METHODS
  During development of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) Sexual Function measure, we collected focus group and survey data on communication with oncology professionals about sexual problems. We conducted 16 focus groups with patients and survivors (n = 109) and analyzed the discussions for major themes, including experiences discussing sex during oncology visits. During testing of the PROMIS Sexual Function measure, we assessed experiences discussing sexual problems with oncology professionals (n = 819) and measured bivariate associations between asking for information from clinicians and sexual function and satisfaction with sex life.
  
  
  RESULTS
  Most patients and survivors (74%) thought that discussions with oncology professionals about sexual problems were important, but whether they had ever received information about sexual function from a provider varied by cancer type (23% lung, 29% breast, 39% colorectal, and 79% prostate). Those who had asked an oncology professional about sexual problems had significantly greater interest in sexual activity as well as more sexual dysfunction.
  
  
  CONCLUSIONS
  Sexual problems are a widespread concern among patients and survivors, but there is much variation in experiences of communication about sexual issues, and many patients do not receive the information they need from their oncology providers. There are large differences in sexual function between patients who do and do not ask providers about sexual problems. Sexual health has yet to be fully integrated into oncology care, even for cancers involving sex organs.
authors.affiliation: Duke Clinical Research Institute, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27715, USA. kathryn.flynn@duke.edu
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Flynn
authors.forename: Jennifer Barsky
authors.initials: JB
authors.lastname: Reese
authors.forename: Diana D
authors.initials: DD
authors.lastname: Jeffery
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Li
authors.initials: L
authors.lastname: Lin
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Shelby
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Dombeck
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Weinfurt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003075:Coitus / Q000502:physiology / Q000523:psychology*; D003142:Communication; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D009657:North Carolina; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012735:Sexual Dysfunction, Physiological / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors